Permit I
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CITY OF TIGARD
PLUMBING PERMIT
COMMUNITY DEVELOPMENT COMMUNITY PLM2009 -00361
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/23/2009
Parcel: 2S 109AB 15300
Jurisdiction: Tigard
Site address: 13294 SW Alpine View DR
Subdivision: ALPINE VIEW Lot: 34
Project: Alpine View
Project Description: Irrigation backflow device.
Owner: FEES
WEST HILLS DEVELOPMENT Quantity Description Date Amount
735 SW 158TH AVE.
BEAVERTON, OR 97406 1 ea Backflow Preventer 12/23/2009 $31.27
PHONE: 503 641 -7342 1 12% State Surcharge - 12/23/2009 $8.70
Plumbing
41 ea Minimum Fee Adjustment - 12/23/2009 $41.23
Contractor: Plumbing
TRADEMARK LANDSCAPES INC
P. O. BOX 2410
OREGON CITY, OR 97006
PHONE: 503 -631 -3893
FAX: 503 -631 -4737
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: � Permittee Signature: I. r
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1 'DEC -23 -2009 WED 10:56 AM FAX NO. 5036417661 P. 05
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i I I I I I I I` 1 II�II `` 14 tii' pp; I t l 1 1 1 1 iliIIII'll�l al II ' I lli',uP.�l' '' l' " 11 I Ip1 "I 1 Fire sprinkler( sq. ft.)
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Job site address: 13294 SW ALPINE VIEW DRIVE
Catch basin or area drain MIMI
City /Slate /ZIP: TIGARp, OR 97224 Drywoll, leach lino, ar trench drain
18.76
Suite/bldg. /apt. no.: Project name: - Footing drain (no. linear ft.. :) Page 2 ��
Cross sheer /directions to job site: M anufactured home utilities 50.03
Manholes w
Rain drain connector
Sanitary sewer (no. linear ft.: :, Page 2
Storm sower (no. linear IL; �) Pfl c 2
Subdivision: ALPINE
1 Wat service (no. linear ft.: �� g
VIEW Lot no.: 34
Tax map /parcel no.: .25 1 0 9 Fixture or item:
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K FLOW PERMIT Clothes washer
25.02
BACK'
I Dishwasher
Drinking fountain 25.02
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i l , Expansion tank WEST HILLS DEVELOPMENT 12'51
A
Fixture /sower cap 25 02
Address: 735 SW 158 AVE Floor drain /floor sink/hub
all 25
City /State /ZI1': I3CAVERTON, OR 97006 Garbage disposal 25.02
Phone: (503)641 -7342 Fax: ( ) Hose bib 5 02
503 641 -7661 2
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Business name: WEST HILLS DEVELOPMENT1 1
— Medical gas (value: $ ) Page 2
Contact nume: WILSON Primer
`' 12.51
Address: 735 SW 15ei AVENUE Roof drain (commercial) 12,51
City/State/ZIP: BEAVERTON, O}Z9700G Sink/basiNlavato_ry 2$.02
Phone: (503) 726 -7033 Solar units (potable water) 25 02 MI
Fax: (503) 641 -7661 Tub /shower /shower pan IMIRE91
E -mail; mwiltlon` @urborhomes.cot» Urinal
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Business name: TRADEMARK LANDSCAPE Water hooter
5 5 .52
Address: P.O. BOX 2410 Water piping/DWV 6 29
City /State /ZTP: OREGON CITY, OR 97045 OOther: ME
256.02
Phone; (503) 631 -3893 Subtotal 31.27
Fax: (503) 631 -4737 1 Minimum permit fee: 572,50 72.5
CCB Lic.: 6796
Plumbing Lic. no.: 2383780 Plan review (25% of permit fee)
Authorized signature- (! l� � Stare surcharge (12% of permit fee)
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Print name: MIRIAtiI WiLS1lN TOTAL PERMIT FEE �7 ,a r
Date: 12/23 I This permit application expires Ira permit is not obtained within 180 days
after it hur been accepted as complete,
'Fee methodology ,et by Tri•County Building Industry Service+ Board.
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